The incidence of thyroid cancer continues to increase largely because of incidental find- ings, but given the excellent prognosis of these cancers, mortality has remained relatively stable. Surgical options for low-risk thyroid cancers include lobectomy and total thyroidectomy. Total thyroidectomy is associated with a higher complication rate with no significant added oncologic value over lobectomy.
Active surveillance is an appropriate alternative to surgery for very-low-risk differentiated thyroid cancers. There remains reluctance to choosing active surveillance because of physician- and patient-driven factors. A patient’s quality of life can be significantly affected by any given treatment. Patients must be counseled appropriately to choose the optimal treatment individualized to their tumor characteristics and personal needs.
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